Last 2017 repeal effort fails: ACA remains law of the land

In July, Republicans made dramatic efforts to pass Affordable Care Act (ACA) repeal and replace legislation. Middle of the night theatrics played out a failed vote as Senator John McCain (AZ) cast the deciding “no” vote. For all intents and purposes, it appeared that Republicans were moving on from health care reform and looking towards immigration or tax reform. However, this September, Republicans decided to make one last-ditch effort to surge for repeal and replace. 

Why revive repeal and replace? 

One of the primary reasons is Republicans faced a deadline based on the budget reconciliation rules for a simple majority vote—51 votes instead of 60 votes. The budget reconciliation rules expire on September 30, after which Republicans would be required to get 60 votes to pass any repeal and replace effort. Recognizing the impending deadline, Republicans dug into their back pocket and pulled out the Graham-Cassidy bill, which had originally been introduced in July. In essence, this bill took the subsidy funding of the ACA and turned it into block grant funding, allowing states to control the fate of health care for their own citizens.

The Graham-Cassidy bill, like its repeal and replace predecessors, faced almost immediate opposition.

On September 22, eight days before the budget reconciliation rules were set to expire, Senator McCain announced his disapproval of and opposition to the bill, citing its lack of a full CBO score and of bipartisanship. Senator Rand Paul (KY) refused to support the bill for far different reasons, primarily because he believed the Graham-Cassidy bill kept too much of the ACA intact.

With only two projected “no” votes at this point, the Graham-Cassidy bill was still in contention to pass.

The partial CBO assessment

On Monday, September 25, a partial CBO assessment of the bill was released, projecting both a reduction in the federal deficit and loss of coverage for millions of Americans. This led Senator Susan Collins (ME) to publicly declare her opposition to the bill.

These three forecasted “no” votes, along with skepticism by other Republicans, were enough to sink the chances of the bill passing.

After a Tuesday afternoon Republican caucus meeting, Senate Majority Leader Mitch McConnell (KY) and a number of other Republican senators announced they would not hold a vote for the Graham-Cassidy bill and instead would focus on tax reform efforts.  

Where we stand today

With the Graham-Cassidy bill withdrawn, the ACA remains alive and well. This means employers who are subject to the Employer-Shared Responsibility Tax should either renew or (hopefully) continue their compliance efforts for the 2017 tracking and reporting year.

The IRS has already taken several steps to notify employers that they fully anticipate enforcing and carrying out reporting this year. These include efforts to enforce penalties for prior year failures to file and updating the 2017 forms and e-filing system.

Throughout this year, SyncStream Solutions remained at the forefront of health care reform, and we will continue to do so, ensuring that employers are always utilizing an updated, compliant solution.